Microbiota intestinal em desordens gestacionais: revisão sistemática

Abstract

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are gestational disorders that involve inflammation and alteration of the intestinal microbiota. In this context, the aim of this study was to investigate the characteristics of the intestinal microbiota of pregnant women with PE or GDM, identifying the similarity between the two clinical conditions, and their role in the etiology and pathophysiology of these diseases. This systematic review was conducted through searches in the PubMed, Embase, Lilacs and Scopus databases. A formal protocol was registered in the PROSPERO database. The quality of the selected studies was assessed based on the Joanna Briggs Institute. After the search procedure, a total of 7,715 articles were identified. Of these, 35 studies were selected to compose the present review, 22 investigating GDM and 13 studies with PE, with sample sizes ranging from 5 to 120 women. It was observed that the phylum Bacteroidetes, the family Lachnospiraceae, the genera Blautia and Ruminococcus were increased in both disorders, and the family Ruminococcaceae was reduced in both gestational disorders. From these findings, it is possible to observe that the abundance of Bacteroidetes Blautia and Ruminococcus can be considered a bacterial signature of the gestational disorders PE and GDM. The other strains Lachnospiraceae and Ruminococcaceae still require more detailed analysis regarding their role in the development of these disorders, mainly regarding the possible physiological mechanisms from the production of metabolites. Aiming at the prevention of these disorders and the occurrence of adverse outcomes, it is possible to have a perspective of modulation of the intestinal microbiota from the observation of factors such as dysbiosis and reduction of diversity.